MCG is now the first option using technology for the control of insulin-dependent diabetes and health authorities of many countries have approved financing of these devices, at least for DM1.
But we are facing two somewhat problematic situations.
First, when all people with DM1 have MCG, what would be the indications of an insulin pump? Probably it would be those used traditionally, poor control or unacceptable hypoglycemia despite MCG. But does it make sense in these cases to use an insulin pump not connected to a sensor? If the pump is prescribed to a patients that already has a sensor, the logic tells us that a pump to be used should be connected to the sensor with an associated infusion control algorithm for preventing hypoglycemia or for automatic control of insulin basal rate (hybrid systems).
First, when all people with DM1 have MCG, what would be the indications of an insulin pump? Probably it would be those used traditionally, poor control or unacceptable hypoglycemia despite MCG. But does it make sense in these cases to use an insulin pump not connected to a sensor? If the pump is prescribed to a patients that already has a sensor, the logic tells us that a pump to be used should be connected to the sensor with an associated infusion control algorithm for preventing hypoglycemia or for automatic control of insulin basal rate (hybrid systems).
Secondly, there is a numerous group of people with continuous insulin infusion systems, now entitled to financing an unconnected MCG system. Although the evidence is still scarce, it seems obvious that if the MCG were connected to the pump and an insulin infusion automatic or semi-automatic system could be implemented, in most cases hypoglycemia could be avoided and the control would improve. So, in this group of people, it would be worth using MCG systems connected with insulin infusion systems. The increase of costs would not be very important, and the benefits would be.
Free diabetes 